What exactly is a healthy diet for getting pregnant?

Foods and fertility are linked. If you and your partner stick to a healthy, varied diet of whole foods, you may be able to boost your chances of conceiving (Homan 2007).

So, what is a healthy diet? A healthy diet simply means eating a balanced variety of foods, ideally fresh, whole foods. Try to include the following:

At least seven or eight servings a day of fruit and vegetables, whether fresh, frozen, canned or dried. Half a cup of cooked broccoli and half a cup of orange juice are each one serving.

Plenty of whole grain products, such as whole grains like quinoa, whole grain bread, pasta, cereals, and rice. Try to have six to seven servings over your day. A serving is half a cup of pasta, rice or one slice of bread.

Some protein, such as lean meat and poultry, fish, eggs and legumes (beans and lentils). Aim for two servings a day.

Fish should make up about two servings a week. Choose oily fish often.

Some low-fat dairy foods, which contain calcium. Aim for two servings a day. Three quarters cup of yogurt or one cup of one or two per cent milk is a serving.

Some iron-rich foods, such as red meat, legumes, dried fruit, bread, green vegetables and fortified breakfast cereals. These build up your resources of iron in preparation for pregnancy.

Try to have something containing vitamin C, such as a glass of fruit juice, with iron-rich meals. This can help you to absorb iron from non-meat sources.
Make cakes, pastries, soft drinks and some takeout and fast foods an occasional treat. These tend to be high in fat, sugar and salt. They may fill you up, but they aren't usually nutritious.

If you're wondering when you should start to improve your diet, there's no time like the present. A healthy diet is important both before and during pregnancy.

What about my weight?

Try to get as close as possible to your recommended weight before trying for a baby. Ideally, your body mass index (BMI) should be between 18.5 and 25 (Barrowclough 2009, BNF 2006).

Being overweight or underweight can reduce your chances of conceiving (NCCWCH 2004, Homan et al 2007, Nice 2010, SIGN 2010), because you may ovulate less often. But there are other good reasons for getting to a healthy weight before you begin trying for a baby.

Being underweight before conceiving is linked to an increased risk of having a baby with a low birth weight or who is small-for-dates (Barrowclough 2009). Your doctor may refer you to a dietitian who will be able to advise you about the best ways to gain weight.

Being overweight before conceiving has been linked to increased risk of complications once you're pregnant. Dieting during pregnancy is not recommended, so now's a great time to start (Williamson 2006). Talk to your doctor if you need advice about changing your diet or starting exercise. Aim to lose no more than between 0.5kg (1lb) and 1kg (2lb) a week (NICE 2010).

Exercise is important, too. If you build it into your daily routine, perhaps walking briskly to work, getting off the bus one stop earlier, or taking the stairs (NICE 2010), it will be more achievable.

Joining a group can help you to stay motivated to lose weight and keep it off. You'll be offered regular advice on exercise and diet, as well as support from others (NCCWCH 2004: 29).

See your doctor if any of these apply to you, as you may need a prescription for the higher dose.

As well as taking a folic acid supplement, eat plenty of foods rich in the naturally occurring form of folic acid, called folate. Foods rich in folate include dark green leafy vegetables such as spinach, kale, citrus fruits, nuts, fortified bread and some fortified breakfast cereals.

You may also want to take a 600IU (International Unit) daily dose of vitamin D. If you're taking a prenatal multivitamin, vitamin D may be included, so check the label.

Some over-the-counter supplements may contain large doses of vitamins and minerals which could be harmful to a developing baby. Only take a vitamin supplement tailored to women who are trying to conceive or who are pregnant. The supplement should not contain the retinol form of vitamin A or fish liver oil.

Should I cut back on alcohol yet?

The Society of Obstetricians and Gynaecologists Canada recommends that women should stop drinking alcohol when they are pregnant. Since many women don’t know they are pregnant immediately, it’s best to cut out all drinking while you are trying to conceive. There is no known safe limit to alcohol during pregnancy. Also, heavy drinking may affect your fertility, so reducing your intake before you try for a baby makes sense (Homan et al 2007).

If cutting down is proving difficult for you, ask your doctor for advice (CKS 2007).

Will caffeine make it harder for me to conceive?

There's no clear evidence that caffeine causes fertility problems. However, some studies have suggested a link between high doses of caffeine and problems with conceiving (Anderson et al 2010, Homan et al 2007, OTIS 2011).

Health Canada advises pregnant women to limit their intake of caffeine. If you have a caffeine habit, it could be worth weaning yourself off it now.

So, how much is too much? Try to keep your caffeine intake to no more than 300mg a day. Once you are pregnant you can reduce that amount to 200mg of caffeine to be safe. You may be interested in getting your body used to that reduced amount now (or you may be curious about what’s ahead). Here are some common drinks and how much you can drink before reaching 200mg:

The caffeine content of espressos, and coffees based on espressos, such as cappuccinos and lattes, can depend on the outlet. One study found that caffeine levels can range from 50mg per espresso at one chain to as much as 300mg per espresso in another (Crozier 2010).

Some cold and flu remedies also contain caffeine. Always check the label, and ask your pharmacist if you're not sure (NHS 2010).

Is there anything I need to be careful about eating or drinking?

Don't eat foods which are high in the retinol form of vitamin A, such as liver and liver products, including pate. The vegetable form of vitamin A, betacarotene, is fine.

Some supplements contain retinol because they use fish liver oil, so these should also be avoided. Too much retinol in your body once you're pregnant could harm your baby (Barrowclough 2009, CKS 2007).

Don't eat fish shark, swordfish or marlin or other predatory fish. These fish can contain mercury.

Eat at least two servings a week of oily fish a week. Oily fish include mackerel, sardines, salmon, trout, fresh tuna, and herring.

Homan GF, Davies M, et al. 2007. The impact of lifestyle factors on reproductive performance in the general population and those undergoing fertility treatment: a review. Human Reproduction Update. 13:209–23. www.humupd.oxfordjournals.org [Accessed December 2011]

NCCWCH. 2004. Fertility: assessment and treatment for people with fertility problems. National Collaborating Centre for Women's and Children's Health London: NICE www.nice.org.uk [Accessed December 2011]

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